During 2005 public hospitals in Queensland
were racked by a number of major scandals. A number of government
reviews were set up.

Briefly

Waiting lists:- Public hospitals had
been underfunded and mismanaged for at least 20 years by a
bureaucracy out of touch with the health care content. Market
managerialism had been introduced in which targets were set.
Credibility, remuneration, careers and hospital funding were linked
to goals set by politicians. This was simply the culmination of
something which had been going on for years. I am aware that doctors
had been complaining about the way the system was run for that period
at least.

Because the system could not cope hospital
waiting lists had grown until they were a disgrace and there had been
much publicity. The government put pressure on to hospitals to
increase productivity and the central health administration passed
the pressures down the system. Government published waiting list
times regularly boasting of them as a measure of productivity as they
were reduced.

What had actually happened was that the
administration in the hospitals had blocked appointments to see
specialists. Instead of waiting to have their surgery patients were
waiting to see the specialists to be investigated and diagnosed. What
this meant was that patients with urgent conditions were not seen and
diagnosed so they were not put on to the urgent waiting lists.
Patients with cancers and other urgent conditions were not getting
priority and their care was being delayed much more than before. The
situation was actually far worse than it had been.

Doctors:- During the 1970s and 1980s
the current ideology decreed that doctors generated work regardless
of the real need and so kept costs up. There were far too many
doctors. Government ignored doctors and university advice and reduced
the medical school places. By the 1990s there was a major shortage of
doctors and this shortage was maximal in the country, particularly in
Queensland.

Foreign doctors were required to write the
AMC exams to see that they were safe. If they were specialists then
they were vetted by the specialist colleges. Many foreign doctors
could not pass the exams or did not want to do so.

In desperation government went recruiting
around the world and arranged for doctors to have temporary
registration with the medical board that would allow them to work
under supervision. The idea was that they would eventually sit the
exam but many did not. In addition to this the staffing was such that
there simply were not enough trained Australian doctors in these
hospitals to properly supervise and train these doctors.

The scandal:- The bubble finally burst
when an Indian trained surgeon, Dr. Patel who had been working in the
USA was contracted to go to the Bundaberg hospital. His competence
had been a problem in the USA where there had been scandals. He was
barred from operating in one state and precluded from performing
major surgery in another. This information was missing from his
registration documents but the board did not follow it up. He was not
vetted by the college of surgeons.

The doctor's personality clearly impressed
and not only was he soon doing large numbers of major operations but
he was made head of surgery. He was hard working and productive doing
large numbers of major operations which brought the hospital more
funding. Management was delighted. These were the operations he had
been prevented from doing in the USA.

Complaints about complications and deaths
made by staff to the hospital's administration were simply ignored.
Complaints to the Health Department were not promptly dealt with. It
was not until an intensive care nurse persuaded a Member of
Parliament to raise it under parliamentary privilege that the scandal
was exposed. Multiple patients had died. Dr Death as he is now known
is to be charged with manslaughter - but he had long since fled to
the USA assisted by one of the hospital administrators.

In the resulting inquiries system wide
failures, maladministration, and several other examples of problem
doctors were exposed. It was found that an unregistered psychiatrist
from Russia who had been accused of paedophilia in that country
treated patients here and was quietly sidelined without telling
anyone when it was discovered. In another hospital the doctors were
doing surgery for which they were not trained without proper
supervision. It all became a huge political issue.

I do not intend to write further about this,
as there has been extensive publicity. I simply want to stress that
because this was in a public hospital it does not invalidate
my
arguments (pdf file). As in corporate
scandals there were financial implications and carrots. The primary
problem was that the strong pressures introduced by politicians were
extraneous to the care of patients. Because of them failures in care
were simply ignored and as a consequence they operated in exactly the
same manner as pressures for profits do in corporate
hospitals.

The progress of the investigation was in fact
complex and there was a trail of legal conflict, political hot air.
and investigation.